|
|
(222 intermediate revisions by 20 users not shown) |
Line 1: |
Line 1: |
| ==Weaning==
| | {{ACM}} {{SemRikken}} |
| ===Overview===
| |
| Weaning of mechanical ventilator is gradual withdrawal of
| |
| ventilatory support through utilization of a variety of ventilator modes,
| |
| periods of total spontaneous ventilation, and appropriate rest periods for
| |
| muscle unloading. Discontinuation of mechanical ventilation should occur as
| |
| soon as the patient is able to protect his/her airway and sustain a
| |
| physiologically-competent minute ventilation while important indicators of
| |
| disease show resolution
| |
|
| |
|
| ===criteria for Spontaneous Breathing Trial (SBT)===
| |
|
| |
|
| *Respiratory Criteria
| | ''SANDBOX'' |
| | | [[File:Captura de Pantalla 2024-05-18 a la(s) 9.33.11 p.m..png]] |
| #PaO2>= '''60 mm hg''' ( FiO2<40-50,PEEP<5-8cm H2O)
| |
| #PaCo2 normal or base line
| |
| #Pt able to initiate inspiratory effort
| |
| | |
| *Cardiovascular Criteria
| |
| #No evidence of myocardial ischemia
| |
| #HR<140/min
| |
| #BP normal without vasopressor or minimal vasopressor support
| |
| #Adequate mental status :''arousable/GCS.13''
| |
| *Absence of correctable comorbid conditions
| |
| #Patient is afebrile
| |
| #No significant electrolytes abnormalities
| |
| ===Patient who will tolerate Weaning===
| |
| the criteria that predict the patient tolerance to weaning are
| |
| #Tidal volume :5-7 ml/Kg
| |
| #respiratory rate is :10-18 per minute
| |
| #total ventilation:5-6 L /min
| |
| #RR/Vt ratio :40-50/L
| |
| #'''MIP''' ( maximum inspiration pressure )between 90- to -120 cm H2O
| |